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Michael Hutchinson - One of the best experts on this subject based on the ideXlab platform.
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Mood disorder affects age at onset of adult-onset Cervical Dystonia
Clinical Parkinsonism & Related Disorders, 2020Co-Authors: Ihedinachi Ndukwe, Sean O'riordan, Cathal Walsh, Michael HutchinsonAbstract:Abstract Introduction Mood disorder is common in Cervical Dystonia, affects quality of life and may precede the onset of the Dystonia. There is controversy as to whether mood disorder is part of the primary process or secondary to the disability. We assessed the characteristics of Cervical Dystonia patients in relation to a past history of mood disorder. Methods At a University Hospital clinic, in all consenting patients with Cervical Dystonia, we uniformly collected demographic data, medical history, and prospectively, measures of prevalent mood disorder. Results In 193 patients (128 women and 65 men) mean age at onset was 43.9 years and mean duration of Cervical Dystonia was 17.5 years. Men had earlier age at onset of Cervical Dystonia than women (p = 0.0037). A history of a mood disorder was reported in 53/128 (41%) women with a significantly earlier median age at onset of Cervical Dystonia (42 years) than 75/128 (59%) women with no history of mood disorder (48 years) (p = 0.005); 33 (26%) women with mood disorder prior to Dystonia also had an earlier age at onset of Dystonia than the 75 without such a history (p = 0.0154). A history of mood disorder was more common in women (41%) than men (31%); 54/128 (42%) women and 21/65 (32%) men had current mood disorder symptoms. Conclusions In our Cervical Dystonia clinic population significant differences in the age at onset in women with, and without, a history of mood disorder strongly indicates that anxiety and depression are primary non-motor (and premotor) symptoms of Cervical Dystonia.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro‐Tectal Pathway
Tremor and other hyperkinetic movements (New York N.Y.), 2018Co-Authors: Rebecca Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) = 4.76, p = 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square = 1.13, p = 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square = 3.57, p = 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro-Tectal Pathway
Columbia University Libraries, 2018Co-Authors: Rebecca B. Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) 5 4.76, p 5 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square 5 1.13, p 5 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square 5 3.57, p 5 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia
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Cervical Dystonia: a disorder of the midbrain network for covert attentional orienting.
Frontiers in neurology, 2014Co-Authors: Michael Hutchinson, Tadashi Isa, Anna Molloy, Okka Kimmich, Laura Williams, Fiona Molloy, Helena Moore, Daniel G. Healy, Timothy Lynch, Cathal WalshAbstract:While the pathogenesis of Cervical Dystonia remains unknown, recent animal and clinical experimental studies have indicated its probable mechanisms. Abnormal temporal discrimination is a mediational endophenotype of Cervical Dystonia and informs new concepts of disease pathogenesis. Our hypothesis is that both abnormal temporal discrimination and Cervical Dystonia are due to a disorder of the midbrain network for covert attentional orienting caused by reduced gamma-aminobutyric acid inhibition, resulting from, in turn, from as yet undetermined, genetic mutations. Such disinhibition is a) subclinically manifested by abnormal temporal discrimination due to prolonged duration firing of the visual sensory neurons in the superficial laminae of the superior colliculus, b) clinically manifested by Cervical Dystonia due to disinhibited burst activity of the cephalomotor neurons of the intermediate and deep laminae of the superior colliculus. Abnormal temporal discrimination in unaffected first-degree relatives of patients with Cervical Dystonia represents a subclinical manifestation of defective gamma-aminobutyric acid activity both within the superior colliculus and from the substantia nigra pars reticulata. A number of experiments are required to prove or disprove this hypothesis.
Andrea Stenner - One of the best experts on this subject based on the ideXlab platform.
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Smell and taste in Cervical Dystonia
Journal of Neural Transmission, 2020Co-Authors: Thorsten Herr, Thomas Hummel, Marcus Vollmer, Carsten Willert, Birgitt Veit, Julie Gamain, Robert Fleischmann, Bernhard Lehnert, Januwe Mueller, Andrea StennerAbstract:The pathophysiology of Cervical Dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between Cervical Dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of Cervical Dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic Cervical Dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of Cervical Dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that Cervical Dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p
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smell and taste in Cervical Dystonia
Journal of Neural Transmission, 2020Co-Authors: Thorsten Herr, Thomas Hummel, Marcus Vollmer, Carsten Willert, Birgitt Veit, Julie Gamain, Robert Fleischmann, Bernhard Lehnert, Januwe Mueller, Andrea StennerAbstract:The pathophysiology of Cervical Dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between Cervical Dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of Cervical Dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic Cervical Dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of Cervical Dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that Cervical Dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p < 0.001), while no difference was found in odor discrimination (12.0 ± 2.5 versus 12.9 ± 1.8; p = 0.097). Regression analysis suggests that age is the main predictor for olfactory decline in subjects with Cervical Dystonia. Moreover, performance in the Montreal Cognitive Assessment is a predictor for gustatory decline in Cervical Dystonia subjects. Findings propose that Cervical Dystonia is associated with diminished olfactory and gustatory functioning.
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The phenomenology of Cervical Dystonia
Fortschritte der Neurologie-Psychiatrie, 2009Co-Authors: G Reichel, Andrea Stenner, A JahnAbstract:Cervical Dystonia is the most common form of focal Dystonia. Most cases of Cervical Dystonia are idiopathic and generally it is a life-long disorder. In recent years, Botulinum toxin type A (BtA) has become the first line therapy. However, some patients are resistant to it. This problem leads to the study of the clinical forms of Cervical Dystonias with the help of CT and MRI. 78 patients with diagnosed primary Cervical Dystonia were examined. All underwent CT of the soft tissues of the neck with the aid of slices at the level of Cervical vertebra 3 and 7. The Cervical spine and the soft tissues of the neck were examined using magnetic resonance tomography in T 1 and T 2 with a slice thickness of 2 mm and in T 1 tilted towards the deep neck muscles. For comparison the MRT image data of 50 patients who had no Cervical Dystonia was analysed. The largest diameters were measured and the shape of all muscles captured in the neck region was described, including the small neck muscles. It was shown that in lateral flexion and in rotation, in 1 / 5 of patients the disorder affected only muscles which work on atlanto-occipital joints (latero- or torticaput), and in a further 1 / 5 it affected only muscles which work on the Cervical spine (latero- or torticollis). 3 / 5 showed both disorders, but with a different degree of caput and collis involvement. Thus a ration of 1:1:3 was obtained in relation to this. 1. In lateral tilt, differentiation between laterocollis and laterocaput is clinically possible. 2. Lateral shift always occurs when laterocollis is present on one side and laterocaput on the other. 3. In rotation, clinical differentiation between torticollis and torticaput is not always possible. In this case CT sections at levels C 3 and C 7 are recommended. By comparing the vertebral position at the two levels it is possible to differentiate reliably between torticollis and torticaput. 4. Anteflexion--differentiation between anterocollis and anterocaput--is analysed by lateral inspection of the angle between the Cervical spine and the thoracic spine or between the Cervical spine and the base of the skull. The same applies for the analysis of retroflexion, the differentiation between retrocollis and retrocaput. 5. A posteroanterior sagittal shift requires no further diagnosis: it is often caused by bilateral dystonic activity of the sternocleidomastoid muscles.
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The phenomenology of Cervical Dystonia
Fortschritte Der Neurologie Psychiatrie, 2009Co-Authors: G Reichel, Andrea Stenner, A JahnAbstract:Background Cervical Dystonia is the most common form of focal Dystonia. Most cases of Cervical Dystonia are idiopathic and generally it is a life-long disorder. In recent years, Botulinum toxin type A (BtA) has become the first line therapy. However, some patients are resistant to it. This problem leads to the study of the clinical forms of Cervical Dystonias with the help of CT and MRI. Patients and methods 78 patients with diagnosed primary Cervical Dystonia were examined. All underwent CT of the soft tissues of the neck with the aid of slices at the level of Cervical vertebra 3 and 7. The Cervical spine and the soft tissues of the neck were examined using magnetic resonance tomography in T 1 and T 2 with a slice thickness of 2 mm and in T 1 tilted towards the deep neck muscles. For comparison the MRT image data of 50 patients who had no Cervical Dystonia was analysed. The largest diameters were measured and the shape of all muscles captured in the neck region was described, including the small neck muscles. Results It was shown that in lateral flexion and in rotation, in 1 / 5 of patients the disorder affected only muscles which work on atlanto-occipital joints (latero- or torticaput), and in a further 1 / 5 it affected only muscles which work on the Cervical spine (latero- or torticollis). 3 / 5 showed both disorders, but with a different degree of caput and collis involvement. Thus a ration of 1:1:3 was obtained in relation to this. Conclusions 1. In lateral tilt, differentiation between laterocollis and laterocaput is clinically possible. 2. Lateral shift always occurs when laterocollis is present on one side and laterocaput on the other. 3. In rotation, clinical differentiation between torticollis and torticaput is not always possible. In this case CT sections at levels C 3 and C 7 are recommended. By comparing the vertebral position at the two levels it is possible to differentiate reliably between torticollis and torticaput. 4. Anteflexion--differentiation between anterocollis and anterocaput--is analysed by lateral inspection of the angle between the Cervical spine and the thoracic spine or between the Cervical spine and the base of the skull. The same applies for the analysis of retroflexion, the differentiation between retrocollis and retrocaput. 5. A posteroanterior sagittal shift requires no further diagnosis: it is often caused by bilateral dystonic activity of the sternocleidomastoid muscles.
Thorsten Herr - One of the best experts on this subject based on the ideXlab platform.
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Smell and taste in Cervical Dystonia
Journal of Neural Transmission, 2020Co-Authors: Thorsten Herr, Thomas Hummel, Marcus Vollmer, Carsten Willert, Birgitt Veit, Julie Gamain, Robert Fleischmann, Bernhard Lehnert, Januwe Mueller, Andrea StennerAbstract:The pathophysiology of Cervical Dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between Cervical Dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of Cervical Dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic Cervical Dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of Cervical Dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that Cervical Dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p
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smell and taste in Cervical Dystonia
Journal of Neural Transmission, 2020Co-Authors: Thorsten Herr, Thomas Hummel, Marcus Vollmer, Carsten Willert, Birgitt Veit, Julie Gamain, Robert Fleischmann, Bernhard Lehnert, Januwe Mueller, Andrea StennerAbstract:The pathophysiology of Cervical Dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between Cervical Dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of Cervical Dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic Cervical Dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of Cervical Dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that Cervical Dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p < 0.001), while no difference was found in odor discrimination (12.0 ± 2.5 versus 12.9 ± 1.8; p = 0.097). Regression analysis suggests that age is the main predictor for olfactory decline in subjects with Cervical Dystonia. Moreover, performance in the Montreal Cognitive Assessment is a predictor for gustatory decline in Cervical Dystonia subjects. Findings propose that Cervical Dystonia is associated with diminished olfactory and gustatory functioning.
Tadashi Isa - One of the best experts on this subject based on the ideXlab platform.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro‐Tectal Pathway
Tremor and other hyperkinetic movements (New York N.Y.), 2018Co-Authors: Rebecca Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) = 4.76, p = 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square = 1.13, p = 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square = 3.57, p = 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro-Tectal Pathway
Columbia University Libraries, 2018Co-Authors: Rebecca B. Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) 5 4.76, p 5 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square 5 1.13, p 5 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square 5 3.57, p 5 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia
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Cervical Dystonia: a disorder of the midbrain network for covert attentional orienting.
Frontiers in neurology, 2014Co-Authors: Michael Hutchinson, Tadashi Isa, Anna Molloy, Okka Kimmich, Laura Williams, Fiona Molloy, Helena Moore, Daniel G. Healy, Timothy Lynch, Cathal WalshAbstract:While the pathogenesis of Cervical Dystonia remains unknown, recent animal and clinical experimental studies have indicated its probable mechanisms. Abnormal temporal discrimination is a mediational endophenotype of Cervical Dystonia and informs new concepts of disease pathogenesis. Our hypothesis is that both abnormal temporal discrimination and Cervical Dystonia are due to a disorder of the midbrain network for covert attentional orienting caused by reduced gamma-aminobutyric acid inhibition, resulting from, in turn, from as yet undetermined, genetic mutations. Such disinhibition is a) subclinically manifested by abnormal temporal discrimination due to prolonged duration firing of the visual sensory neurons in the superficial laminae of the superior colliculus, b) clinically manifested by Cervical Dystonia due to disinhibited burst activity of the cephalomotor neurons of the intermediate and deep laminae of the superior colliculus. Abnormal temporal discrimination in unaffected first-degree relatives of patients with Cervical Dystonia represents a subclinical manifestation of defective gamma-aminobutyric acid activity both within the superior colliculus and from the substantia nigra pars reticulata. A number of experiments are required to prove or disprove this hypothesis.
Sean O'riordan - One of the best experts on this subject based on the ideXlab platform.
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Mood disorder affects age at onset of adult-onset Cervical Dystonia
Clinical Parkinsonism & Related Disorders, 2020Co-Authors: Ihedinachi Ndukwe, Sean O'riordan, Cathal Walsh, Michael HutchinsonAbstract:Abstract Introduction Mood disorder is common in Cervical Dystonia, affects quality of life and may precede the onset of the Dystonia. There is controversy as to whether mood disorder is part of the primary process or secondary to the disability. We assessed the characteristics of Cervical Dystonia patients in relation to a past history of mood disorder. Methods At a University Hospital clinic, in all consenting patients with Cervical Dystonia, we uniformly collected demographic data, medical history, and prospectively, measures of prevalent mood disorder. Results In 193 patients (128 women and 65 men) mean age at onset was 43.9 years and mean duration of Cervical Dystonia was 17.5 years. Men had earlier age at onset of Cervical Dystonia than women (p = 0.0037). A history of a mood disorder was reported in 53/128 (41%) women with a significantly earlier median age at onset of Cervical Dystonia (42 years) than 75/128 (59%) women with no history of mood disorder (48 years) (p = 0.005); 33 (26%) women with mood disorder prior to Dystonia also had an earlier age at onset of Dystonia than the 75 without such a history (p = 0.0154). A history of mood disorder was more common in women (41%) than men (31%); 54/128 (42%) women and 21/65 (32%) men had current mood disorder symptoms. Conclusions In our Cervical Dystonia clinic population significant differences in the age at onset in women with, and without, a history of mood disorder strongly indicates that anxiety and depression are primary non-motor (and premotor) symptoms of Cervical Dystonia.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro‐Tectal Pathway
Tremor and other hyperkinetic movements (New York N.Y.), 2018Co-Authors: Rebecca Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) = 4.76, p = 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square = 1.13, p = 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square = 3.57, p = 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia.
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Reduced Frequency of Ipsilateral Express Saccades in Cervical Dystonia: Probing the Nigro-Tectal Pathway
Columbia University Libraries, 2018Co-Authors: Rebecca B. Beck, Simone L. Kneafsey, Shruti Narasimham, Sean O'riordan, Tadashi Isa, Michael Hutchinson, Richard B. ReillyAbstract:Background: Cervical Dystonia is a hyperkinetic movement disorder of unknown cause. Symptoms of Cervical Dystonia have been induced in animals in which the integrity of the nigro-tectal pathway is disrupted, resulting in reduced inhibition of the deep layers of the superior colliculus. This same pathway is believed to play a critical role in saccade generation, particularly visually guided, express saccades. It was hypothesized that individuals with Cervical Dystonia would present with a higher frequency of express saccades and more directional errors. Methods: Eight individuals with Cervical Dystonia and 11 age- and sex-matched control participants performed three saccadic paradigms: pro-saccade, gap, and anti-saccade (120 trials per task). Eye movements were recorded using electro-oculography. Results: Mean saccadic reaction times were slower in the Cervical Dystonia group (only statistically significant in the anti-saccade task, F(1, 35) 5 4.76, p 5 0.036); participants with Cervical Dystonia produced fewer directional errors (mean 14% vs. 22%) in the anti-saccade task; and had similar frequencies of express saccades in the gap task relative to our control population (chi-square 5 1.13, p 5 0.287). All Cervical Dystonia participants had lower frequencies of express saccades ipsilateral to their dystonic side (the side to which their head turns), (chi-square 5 3.57, p 5 0.059). Discussion: The finding of slower saccadic reaction times in Cervical Dystonia does not support the concept of reduced inhibition in the nigro-tectal pathway. Further research is required to confirm the observed relationship between the lateralization of lower frequencies of express saccades and direction of head rotation in Cervical Dystonia